Individual provider Active NPI

Josephine Nwoko, GNP-BC

  • Gerontology Nurse Practitioner
  • Millersville, MD
National Provider Identifier
1073860466
Registry record updated Feb 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN1012764 Issued in DC
Practice address
8601 Veterans Hwy
Suite 211
Millersville, MD 21108-1547
Phone
(410) 553-8092
NPI assigned
Aug 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R174691 MD
Gerontology Nurse Practitioner 363LG0600X RN1012764 DC Primary

Addresses

Primary practice location

8601 Veterans Hwy
Suite 211
Millersville, MD 21108-1547

Mailing address

8601 Veterans Hwy
Suite 211
Millersville, MD 21108-1547
Phone (410) 553-8092

Other names 1

  • Josephine Nwachukwu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151112001566 DC Practitioner - Nurse Practitioner 6002057403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health Services IncGroup PAC ID 4385541622, 17 clinicians

Practice addresses (Care Compare)

1150 Varnum St NE
Washington, DC 20017-2104

128 M St NW
PHS Perry Family Health Center
Washington, DC 20001-1205
Phone (202) 854-3840

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Washington, DC, CCN 097024
  • Medstar Washington Hospital Center Hospital, Washington, DC, CCN 090011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R174691MDMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health Services Inc CurrentSince Oct 6, 2015 Accepting new patients
Providence Health Services, Inc CurrentSince Oct 6, 2015 Accepting new patients
Providence Health Services, Inc Past Accepting new patients

Locations

128 M St NW
Washington, DC 20001
Phone (202) 682-3840

1150 Varnum St NE
Washington, DC 20017
Phone (202) 269-7000

1160 Varnum St NE
Ste 317
Washington, DC 20017
Phone (202) 529-1961

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1073860466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 VETERANS HWY",
            "address_2": "SUITE 211",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081547",
            "telephone_number": "410-553-8092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 VETERANS HWY",
            "address_2": "SUITE 211",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081547",
            "telephone_number": "410-553-8092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOKO",
        "first_name": "JOSEPHINE",
        "credential": "GNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-06",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R174691",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "DC",
            "license": "RN1012764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSEPHINE",
            "last_name": "NWACHUKWU",
            "credential": "GNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Millersville, MD

Sources for this page

Verify at the official NPI Registry.